[通过桡骨远端矫正截骨术治疗先天性尺骨撞击综合征 - 临床结果]。

IF 0.4 4区 医学 Q4 SURGERY
Petr Machac, René Schandl, Roman Wolters, Hermann Krimmer
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引用次数: 0

摘要

背景:2016 年,描述了一种治疗 DRUJ 疼痛性撞击综合征的新方法:桡骨远端减压矫正截骨术。临床症状以压迫试验阳性为基础;前臂负重时会出现疼痛。这种现象与变形的乙状切迹和尺骨负变异同时出现,导致骨间膜远端斜束的张力增加。这种情况的病因可能是先天性的,也可能是创伤后或先天性的。通过拟议的截骨术,可实现 DRUJ 的减压。本研究总结了我们的手部中心专门针对先天性病例实施这些手术的结果:患者和方法:通过缩短桡骨远端和闭合楔形截骨术实现 DRUJ 的重塑。通过桡骨轴的尺侧平移来缓解骨间膜。这项研究只包括桡骨远端关节先天不协调的患者。结果采用视觉模拟量表(VAS)和克里默腕关节评分法进行评估,并测量术前和术后的活动范围以及握力:11年间,我们采用这种方法为38名患者实施了45例手术,其中右侧17例,左侧14例,双侧7例。在双侧不协调的病例中,只对有症状的一侧进行了治疗。统计评估显示,VAS 疼痛明显减轻,从 7.2 减轻到 2(p 结论:如果符合适应症标准,避免了禁忌症,并正确实施了截骨术,那么这项技术就能改善患者的功能和生活质量。从预防角度看,对退行性病变进展的影响还有待进一步研究证实。无论如何,这是一种安全的手术,为其他可能的选择留出了余地。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Treatment of Congenital Ulnar Impingement Syndrome by Corrective Osteotomy of the Distal Radius - Clinical Results].

Background: In 2016, a new method was described to treat the painful impingement syndrome of the DRUJ: decompression corrective osteotomy of the distal radius. Clinical symptoms are based on a positive compression test; pain occurs with weight-bearing on the forearm. This phenomenon is seen in conjunction with a deformed sigmoid notch together with ulna minus-variance, which leads to increased tension in the distal oblique bundle of the interosseous membrane. The etiology of the condition can be either congenital, post-traumatic, or iatrogenic. Through the proposed osteotomy, decompression in the DRUJ is achieved. This study summarises the results of these surgical procedures performed in our hand centre exclusively in cases of congenital origin.

Patients und methods: Remodelling of the DRUJ is achieved through the shortening of the distal radius together with closed wedge osteotomy. Relief of the interosseous membrane is accomplished by ulnar translation of the radial shaft. This study only included patients with congenital incongruency in the DRUJ. The results were evaluated using a visual analogue scale (VAS) and the Krimmer Wrist Score and by measuring the preoperative and postoperative range of motion as well as grip strength.

Results: Within 11 years, 45 procedures were performed with our method on 38 patients, of which 17 were treated on the right side, 14 on the left side, and 7 bilaterally. In cases of bilateral incongruency, only the symptomatic side was treated. The statistical evaluation showed a significant reduction of pain on the VAS from 7.2 to 2 (p<0.001). No significant changes were seen in the range of motion (p=0.812). The Krimmer Wrist Score showed good to excellent results in almost 90% of cases.

Conclusion: If the indication criteria are met, contraindications are avoided and the osteotomy is correctly performed, this technique leads to an improvement of patients' functionality and quality of life. From a preventive viewpoint, the influence on the progression of the degenerative changes is yet to be demonstrated in further studies. At any rate, this is a safe procedure, which leaves the path open for other possible options.

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来源期刊
CiteScore
1.00
自引率
16.70%
发文量
85
审稿时长
6-12 weeks
期刊介绍: In Originalarbeiten und Fallberichten finden Sie die neuesten Informationen über: Diagnostik Verfahrenswahl state of the art / neueste Techniken rekonstruktive Verfahren Behandlung infolge von Traumata oder OP Bewertung der Ergebnisse Klinische Forschung Interessante Darstellung der neuesten Erkenntnisse in Originalarbeiten und Fallberichten. Exzellent veranschaulicht durch ein klares Layout und reiche Bebilderung. Überzeugen Sie sich selbst! Organschaften Organ der Deutschsprachigen Arbeitsgemeinschaft für Handchirurgie, Deutschen Gesellschaft für Handchirurgie und Österreichischen Gesellschaft für Handchirurgie Organ der Deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der peripheren Nerven und Gefäße Organ der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen
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